Rethinking Palliative Care


As Benjamin Franklin wrote 235 years ago, the only two certainties in life are death and taxes. In Canada, you can add a third item to that list – debates about health care. Whether times are good or bad, the issue always polls as a top concern. It’s little wonder why: touching every stage of our lives from birth to death, health care impacts our well-being and quality of life, unlike any other area of public policy. 

The stresses of the pandemic revealed weaknesses in Alberta’s healthcare system, including significant shortcomings in primary care, mental health services and care in rural and Indigenous communities. Many have fingered excessive centralization as the culprit. 

Created in 2008, Alberta Health Services (AHS) is the country’s largest integrated provincial health care system. Not only does AHS deliver health services, but it also develops policy and allocates the lion’s share of funding. In response to Albertans’ growing dissatisfaction with the status quo, the provincial government is in the process of reorganizing AHS into four entities to focus on primary care, acute care, mental health and addiction care, and continuing care. 

Intuitively, these four sectors make sense. Another essential sector, however, is clearly missing – palliative care. Far too often, palliative care and continuing care are lumped together. They shouldn’t be. It’s a heartbreaking fact of life that terminal, progressive illnesses can strike anyone, including children and young adults. According to provincial data, 10 to 15 of every 10,000 Albertans under 18 will require such care. 

As Alberta’s need for palliative care inevitably grows alongside its population, we must rethink how we deliver this crucial service. At present, many Albertans are left to spend their final days in the sterile surroundings of a hospital room. This is a poor substitute for hospice care, which aims to combine a warm, homelike setting with around-the-clock palliative care. 

Edmonton is home to one of Canada’s leading models of hospice care. For nearly 28 years, the Pilgrims Hospice Society has offered compassionate care for individuals with terminal illnesses, enhancing dignity and quality of life until the end of life. Through its Roozen Family Hospice Centre, the Society provides palliative care for approximately 200 Albertans a year. When combined with its illness support, caregiver support and grief counselling programming, Pilgrims serves over 3,000 people annually. 

In recognition of Pilgrims’ far-reaching impact, the provincial government, in 2022, provided the Society with a grant to support its services and fund a review of its unique model of care. The data collected will help inform the government’s assessment of hospice care models. Time will tell what direction the province chooses, but Pilgrims offers at least one path forward that would provide care, comfort and dignity to Albertans in their time of greatest need. 

But the benefits wouldn’t end there. A hospice model would also save the health care system thousands of dollars per patient by reducing hospital stays. Health care is far away the province’s largest annual expenditure, and it’s growing by the year. If our system is to be sustainable, the provincial government needs to use finite financial resources as efficiently as possible. 

Looking to the future, Alberta’s unprecedented population growth will open the door to transformative opportunities for diversification and prosperity. But in the more immediate term, it will also present challenges for critical public services like health care. If done right, embracing innovative solutions like those offered by Pilgrims can help us navigate the way.